VIP Culture in Hospitals Can Compromise Patient Safety, Equitable Care: AIIMS Doctors

Preferential treatment for influential patients can undermine equitable access to healthcare, AIIMS Delhi doctors have warned, calling for uniform hospital policies to ensure care is determined by medical needs rather than social status. In an article published in Oncology Reviews, Dr M D Ray, Professor of Surgical Oncology at AIIMS Delhi, and his MCh student Dr Hema Siri Kottu examined the ethical and clinical challenges posed by “VIP syndrome” in resource-constrained hospitals.

The authors said pressure from patients, relatives and hospital administrators could lead to unnecessary investigations, inadequately prepared surgeries and prolonged intensive care unit (ICU) stays, exposing patients to avoidable complications and diverting scarce hospital resources.

They cited the case of a 58-year-old woman with advanced ovarian cancer who underwent surgery without adequate preoperative preparation following pressure from hospital management. Delayed mobilisation contributed to pulmonary complications, extending her hospital stay to 12 days, compared with five days generally required for similar procedures. In another case, relatives of a 60-year-old woman with early breast cancer insisted on a PET-CT scan despite concerns about its necessity. Further investigations found that increased uptake in mediastinal lymph nodes was reactive.

The doctors warned that operating without addressing conditions such as uncontrolled diabetes or recent smoking could increase surgical risks. Unnecessary antibiotics, frequent demands for senior doctors and interference in postoperative care could also disrupt hospital workflows. They recommended clear admission and discharge policies, effective communication with patients and families, and resource allocation based on clinical need.

Dr Ray said every patient deserved dignity, compassion and appropriate treatment. While seeking a second opinion was a legitimate patient right, pressure to bypass essential medical safeguards remained a concern. The authors clarified that their article presents clinical experiences and ethical concerns, rather than findings from a controlled comparative study. The cases illustrate potential risks but do not establish the prevalence of VIP syndrome or quantify its overall impact on patient outcomes. They called for greater awareness and consistent institutional protocols to promote fairness and public trust.